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Related Experiment Videos

Managed care organization liabilities.

J M O'Toole1

  • 1Tri-City Brokerage of Illinois, Inc., USA.

Managed Care Quarterly
|January 2, 1999
PubMed
Summary
This summary is machine-generated.

Managed Care Organizations (MCOs) face new risks from credentialing and physician management. Explore insurance products to protect MCOs and their leadership from emerging claims.

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Area of Science:

  • Healthcare Management
  • Risk Management
  • Insurance Law

Background:

  • Managed Care Organizations (MCOs) offer services like credentialing, network development, and utilization review.
  • These MCO activities involve complex contractual agreements and physician employment decisions.
  • Increased claim exposures have led the insurance industry to develop specialized products for MCOs.

Purpose of the Study:

  • To inform Managed Care Organizations about emerging claims and liabilities.
  • To present available insurance products for mitigating MCO risks.
  • To guide MCOs in selecting appropriate coverage for firm and leadership asset protection.

Main Methods:

  • Review of MCO operational activities and associated risks.
  • Analysis of insurance products designed for healthcare organizations.

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  • Consideration of legal and financial factors influencing insurance choices.

    • Main Results:

    • MCOs face novel risk exposures beyond traditional healthcare liabilities.
    • A variety of insurance coverages are available to address these evolving claims.
    • Purchasing decisions depend on specific MCO risks, contracts, and legal protections.

    Conclusions:

    • MCOs must proactively address new claims and liabilities.
    • Strategic selection of insurance is crucial for protecting organizational and individual assets.
    • Understanding contractual obligations and legal frameworks is key to effective risk management.